On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton.
- Dennis Embleton
- Date:
- 1870
Licence: Public Domain Mark
Credit: On the shoulder-tip pain, and other sympathetic pains, in diseases of the liver / by D. Embleton. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![as one at times well marked, and quotes the first case in which he had observed it. He quotes Roche,* * who states, that in inflammation of the convexity of the liver, “ C’est seulement dans ce cas que la douleur s’etend a la poitrine, au cou, et a I’dpaule du inline cotd,” and that in inflammation of the concavity, “ La douleur ne se propage ni a l’<ipaule, ni au cou, ni riieme a la poitrine,” and Roche quotes, as one of the s^miptoms given of acute hepatitis by Frank, propagation of pain to the light shoulder and clavicle. Trousseauf names tlie pain as occurring during the passage of gall stones, and in ca.ses of hydatids of the liver. Frerichs]: mentions, in liver abscess, the pain in the shoulder, scapula and arm, and says it ceases as soon as the pus finds an outlet; ti)C same pain also in cases of cancer and of gall stones. Hr. S, 11. Ward,II Phj’^sician to the Dreadnought, among the symptoms tolerably conclusive of abscess of the liver, mentions after “ Pain direct, distant pain referable to the right shoulder, and especiaUy localized about the acromion.” festeut jiendant le cours d’uue maLadie du foie, la douleur de l’6paule droite.” This was, “Uue douleur incommode et contmuelle v^ers l’6paule droite ; elle ne cessa p;ia depuis de se faire plus ou moins seutir.” See also Obs. 20. * Dictiomiaire de Medicine en xv vol. tom ix. t Clinique Mediciile de I'Hotel Dieu, 1805, tom hi. ]>p. 219 and 249 — “ Coliques hepatiques.” “Calculs biliares.”—“ Cette douleur descend dans I’abdomen et en quelques cas simule la colique nopliritique; jilus ordinairement elle I’emonte dans la poitrine, jusqu’ au cou, et, phenomriie singulier, qui se recoutre cliez beaucoup d’mdividus, elle reteutit dans l’4paule droite.” I A Clinic.ol Treatise on Diseases of the Liver, 1860, vol. ii. p. 125. New Sydenham Society. Abscess of the Liver.—“ In addition to the local pain, there exists in many cases (according to Louis, in 28 out of 163 cases, or in 17 j)er cent.), a sympathetic pain, ususilly having its seat in the right shoulder, but some- times complaiued of in the scapula and arm ; the sensation is that of tightness or tension, and sometimes of an intolerable boring, and it is aggravated by every concussion of the hepatic region. This symptom usually lasts for a few days only, and ceases as soon as the pus finds an outlet.” Cancer of the Liver, p. 301.—“ Fi'om time to time the symptoms undergo aggravation, the pains become more acute, and extend towanls the shoulders and hips.” Gall Stones, p. 518.—“ These pains (at the margin of the liver and in the epigastrium) are, in most cases very severe, and of a burning or boring character, &c. ; not unfrequently they extend over both hyjxichondria, apd also radiate towards the back, the right shoulder, the neck, &c.” II The Lancet, August 1st, 1868.](https://iiif.wellcomecollection.org/image/b22471911_0013.jp2/full/800%2C/0/default.jpg)
